Stitt wants state’s Medicaid part of federal block grant

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OKLAHOMA CITY - Gov. Kevin Stitt has announced his intent to overhaul Oklahoma’s Medicaid program as part of a new federal block grant program.

Rolled out Thursday morning by officials from the Trump administration, the Healthy Adult Opportunity would allow participating states to request multiple Medicaid rule waivers and the choice of accepting Medicaid funding as either a fixed lump sum or on a per-enrollee basis. In exchange, those states would be required to send in regular real-time reports about Medicaid patient outcomes. It is specifically targeted at adults younger than age 65 who currently do not already qualify for a state-run Medicaid plan. Federal officials reiterated repeatedly that the eligibility of children, the disabled and senior citizens would not be impacted should a state choose to participate in the pilot program.

Speaking at a press conference in Washington, D.C. with Secretary of Health and Human Services Alex Azar and Center for Medicaid Services Director Seema Verma, Gov. Stitt lauded the new federal offering and what it may mean for his proposed SoonerCare 2.0. “With flexibility, we will seek to establish programs that better address Oklahoma’s unique rural needs, such as enhancing provider reimbursement, authorizing telehealth services, and reimagining ‘hospitals’ to expand care options in areas with limited populations,” he said. “And with flexibility, we will seek to expand targeted treatment for opioid addiction and substance abuse. Oklahoma is in the midst of establishing a world-class research institution on opioid addiction. With HAO flexibility, we will be able to more quickly support our communities and implement lessons we are learning and discovering.”

In order to participate in the Healthy Adult Opportunity, a state would have to come up with about $150 million in order to match its maximum federal allocation of $1.1 billion. After the announcement, a representative for the Stitt administration said the governor will be reaching out to the Oklahoma legislature about coming up with that money without raising taxes. Among the programs targeted as potential sources for the $150 million include TSET, the Department of Mental Health and Substance Abuse and the Department of Corrections.

Gov. Stitt also indicated that he wants his proposal completed and submitted to the federal government before voters take up Medicaid expansion at the polls. On Jan. 9, Oklahoma’s Secretary of State certified that the initiative petition for Medicaid expansion met all the requirements to appear on a ballot later this year. However, no timeline has been set for when State Question 802 will go before voters. According to data published Jan. 17 by the Oklahoma Health Care Authority, 781,916 Oklahomans are participating in SoonerCare, the state’s current Medicaid program. Two-thirds are children and almost one-fifth of all adults in the program are elderly, blind or disabled.

In Comanche County alone, 22,267 residents receive Medicaid benefits, including almost 14,000 children. State Rep. Marcus McEntire (R-Duncan), the chairman of the House of Representatives’ Appropriations and Budget Subcommittee on Health, expressed cautious optimism about the proposed overhaul. “At first blush of seeing this plan, I’m optimistic. It does increase access to care and captures our tax dollars and brings them back home,” he said. “It also gives the state unprecedented flexibility in designing and administer- ing Medicaid without raising taxes on Oklahoma citizens or raiding dollars from other core areas of service.” The proposal was also met with bipartisan criticism.

“Republican plans to expand welfare aren’t any better than Democrats’ plans to expand welfare,” Oklahoma Council for Public Affairs President Jonathan Small said. “In fact, sources ranging from the Government Accountability Office to state actuaries have found that Republican plans to expand welfare in Indiana, Arkansas and other places actually cost more than Democrats’ welfare-expansion plans. The broad proposal unveiled today basically adds conservative window dressing to Obamacare’s expansion of Medicaid, and the result of expansion will be the same as what we have seen in other states: exploding costs, higher taxes, and stagnant or worsening health outcomes.” In a joint statement, House Minority Leader Rep. Emily Virgin (D-Norman) and House Democratic Health Care Policy Chairman Rep. Forrest Bennett (D-Oklahoma City) questioned the governor’s decision to be part of an experimental program.

“A serious health care plan provides access to health care to all Oklahomans and does so in a way that is equitable to all citizens and is proven to improve health care outcomes. It seems the governor’s plan fails on all three of these points. Under block grants, lawmakers will determine care, not doctors, and unnecessary red tape will limit services amongst the lowest-paid workers in Oklahoma, who also have the highest tax burden. “This plan is new and yet to be tested. A straight expansion of Medicaid would invest in services that we know work in other states and in Oklahoma. Finally, a direct expansion has gone through the court process, while the governor’s plan has not. Oklahomans are tired of waiting on their government to do what is right. A straight expansion of Medicaid is the easiest way to increase access to health care in the state, and it has been proven to work in other states,” Ms. Virgin said.